Hormonal diseases after traumatic brain injury

Česká verzia

Authors: J. Čáp
Authors place of work: II. interní klinika Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc.
Published in the journal: Vnitř Lék 2006; 52(10): 941-946
Category: Review

Summary

Traumatic brain injury represents major medical and social problem in all developed countries. Its incidence is about 200 per 100 000 inhabitants per year. In the acute phase immediately after injury the posterior pituitary dysfunction is well known. The incidence of severe, grossly hypernatremic, cases of diabetes insipidus (DI) is about 3 %, les severe form of ADH insufficiency was recognized in 21-26 %. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) was described in about 14 %. These changes are transient in most cases, persisting DI has an incidence of 5-7 % and SIADH cases recover almost always. Since the beginning of this century several series evaluating prospectively all patents after moderate a severe TBI have been published. The permanent hypopituitarism was found in one quarter to one half of them. The most common turned out to be the growth hormone (17.6 %) and gonadotropic (13.4 %) deficiency. Less common is the corticotropic (8.4 %) and thyrotropic (4.3 %) insufficiency. In the majority of patient an isolated dysfunction was discovered. In 9 %, however, a combined failure of two or more pituitary was present. This paper describes the minimum investigation needed to diagnose hypopituitary patient after TBI, who may profit from substitution therapy.

Key words:
traumatic brain injury - TBI - hypopituitarism - diagnosis - substitution

Zdroje

1. Bondanelli M, Ambrosio MR, Zatelli MC et al. Hypopituitarism after traumatic brain injury. Eur J Endocrinol 2005; 152: 679-691.

2. Leon-Carrion J, Dominguez-Morales M del R, Barroso Y et al. Epidemiology of traumatic brain injury and subarachnoid hemorrhage. Pituitary 2005; 8: 197-202.

3. Leon-Carrion J, De Serdio-Arias ML, Cabezas FM et al. Neurobehavioural and cognitive profile of traumatic brain injury patients at risk for depression and suicide. Brain Inj 2001; 15: 175-181.

4. Cyran E. Hypophysenschädigung durch Schädelbasisfraktur. Deutsch Med Wochenschr 1918; 44: 1261.

5. Van den Berghe G. Novel insights into the neuroendocrinology of critical illness. Eur J Endocrinol 2000; 143: 1-13.

6. Benvenga S, Campenni A, Ruggeri RM et al. Clinical review 113: Hypopituitarism secondary to head trauma. J Clin Endocrinol Metab 2000; 85: 1353-1361.

7. Yuan XQ, Wade CE. Neuroendocrine abnormalities in patients with traumatic brain injury. Front Neuroendocrinol 1991; 12: 209-230.

8. Agha A, Thompson CJ. Anterior pituitary dysfunction following traumatic brain injury (TBI). Clin Endocrinol (Oxf) 2006; 64: 481-488.

9. Schneider M, Schneider HJ, Stalla GK. Anterior pituitary hormone abnormalities following traumatic brain injury. J Neurotrauma 2005; 22: 937-946.

10. Cohan P, Wang C, McArthur DL et al. Acute secondary adrenal insufficiency after traumatic brain injury: a prospective study. Crit Care Med 2005; 33: 2358-2366.

11. Roberts I, Yates D, Sandercock P et al. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet 2004; 364: 1321-1328.

12. Tsagarakis S, Tzanela M, Dimopoulou I. Diabetes insipidus, secondary hypoadrenalism and hypothyroidism after traumatic brain injury: clinical implications. Pituitary 2005; 8: 251-254.

13. Agha A, Thornton E, O'Kelly P et al. Posterior pituitary dysfunction after traumatic brain injury. J Clin Endocrinol Metab 2004; 89: 5987-5992.

14. Agha A, Sherlock M, Phillips J et al. The natural history of post-traumatic neurohypophysial dysfunction. Eur J Endocrinol 2005; 152: 371-377.

15. Kelly DF, Gonzalo IT, Cohan P et al. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a preliminary report. J Neurosurg 2000; 93: 743-752.

16. Lieberman SA, Oberoi AL, Gilkison CR et al. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. J Clin Endocrinol Metab 2001; 86: 2752-2756.

17. Bondanelli M, De Marinis L, Ambrosio MR et al. Occurrence of pituitary dysfunction following traumatic brain injury. J Neurotrauma 2004; 21: 685-696.

18. Popovic V, Pekic S, Pavlovic D et al. Hypopituitarism as a consequence of traumatic brain injury (TBI) and its possible relation with cognitive disabilities and mental distress. J Endocrinol Invest 2004; 27: 1048-1054.

19. Aimaretti G, Ambrosio MR, Di Somma C et al. Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism: screening study at 3 months after the brain injury. Clin Endocrinol (Oxf) 2004; 61: 320-326.

20. Agha A, Rogers B, Sherlock M et al. Anterior pituitary dysfunction in survivors of traumatic brain injury. J Clin Endocrinol Metab 2004; 89: 4929-4936.

21. Leal-Cerro A, Flores JM, Rincon M et al. Prevalence of hypopituitarism and growth hormone deficiency in adults long-term after severe traumatic brain injury. Clin Endocrinol (Oxf) 2005; 62: 525-532.

22. Schneider HJ, Schneider M, Saller B et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol 2006; 154: 259-265.

23. Tanriverdi F, Senyurek H, Unluhizarci K et al. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J Clin Endocrinol Metab 2006; 91: 2105-2111.

24. Čáp J. Deficit růstovéh hormonu v dospělosti. Interní medicína pro praxi 2005; 5: 237-240.

25. Springer J, Chollet A. A traumatic car crash. Lancet 2001; 357: 1848.

26. Popovic V. GH Deficiency as The Most Common Pituitary Defect After TBI: Clinical Implications. Pituitary 2005; 8: 239-243.

27. Agha A, Thompson CJ High risk of hypogonadism after traumatic brain injury: clinical implications. Pituitary 2005; 8: 245-249.

28. Lorenzo M, Peino R, Castro AI et al. Hypopituitarism and growth hormone deficiency in adult subjects after traumatic brain injury: who and when to test. Pituitary 2005; 8: 233-237.

29. Aimaretti G, Ambrosio MR, Di Somma C et al. Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J Clin Endocrinol Metab 2005; 90: 6085-6092.